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We all scream for Selegiline (and Pindolol)!

Posted by Zeke on December 27, 1999, at 11:46:31

In reply to To Judy and Zeke re: Selegiline and Pindolol, posted by Rick on December 26, 1999, at 18:31:55

> One thing I am fairly sure about is that Pindolol is not a good candidate to help with the fatigue.

That's a good point (the anti-anxiety effect of pindolol and the other beta-blockers). However, the doses of pindolol used with antidepressants are typically lower than those used for hypertension and the anergia is logically much less also.

> ATTACHMENT (from Selegiline monograph):
> It is important to be aware that selegiline may have pharmacological effects unrelated to MAO B inhibition. As noted above, there is some evidence that it may increase dopaminergic activity by other mechanisms, including interfering with dopamine re-uptake at the synapse. Effects resulting from selegiline administration may also be mediated through its metabolites. Two of its three principal metabolites, amphetamine and methamphetamine, have pharmacological actions of their own; they interfere with neuronal uptake and enhance release of several neurotransmitters (e.g., norepinephrine, dopamine, serotonin). However, the extent to which these metabolites contribute to the effects of selegiline are unknown.

A fraction of selegiline is metabolized to to amphetamines and these are levo-methamphetamine and levo-amphetamine, which effect norepinephrine but not dopamine (at least not to any significant degree). Theoretically, this is why the dextroamphetamines are 4 to 6 times stronger than levoamphetamines. Also note that the government allows levo-methamphetamine (aka l-desoxyephedrine) to be sold over the counter in Vicks Inhalers. (Look at the active ingredient listed the nest time you visit your local drug store.) Re serotonin, methamphetamine but not amphetamine has some effect in itself. I'm not sure of how the levo isomer effects serotonin compared to the dextro.

Still, enhancing dopamine processes might reasonably effect serotonin even without imediate interaction of the two drugs.

An additional note about estrogen is that it reportedly increases serotonin by virtue of decreasing production of MAO (MAO-A?). Affective disorders and anxiety in persons with estrogen (and/or testosterone) deficiency is thought to be due to excess MAO which 'mops up' too much serotonin. Estrogen also seems related to Nerve Growth Factor and depressed persons tend to exhibit shrunken hippocampal structures.

Re melatonin, I though you (Judy) might try it at bedtime in place of Xanax -- to allow more REM. I'd think you could continue Xanax at other times. (Just a thought...)




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